Key facts

Transmission

Unwashed hands (after defecating or using a toilet)
Food or water contaminated by stools from a sick person
Contaminated fruits and vegetables
Close physical contact with a sick person

Symptoms

Diarrhoea containing blood.
Fever, abdominal cramps.
Dehydration.

Prevention

Promote safe clean drinking water (including a clean covered water container in the household)
Use appropriate sanitation facilities (sound, clean latrines)
Promote handwashing with soap (especially after using the toilet or cleaning a baby)
Promote good food hygiene (thoroughly cooked food, covered food, clean utensils, etc.)
Encourage exclusive breastfeeding for the first six months of life
Social mobilization and behaviour change communication

Vulnerable people

Children under five years old
Children who are malnourished
People, especially children, with weakened immune systems (for example, as a result of HIV infection)
People living in areas with poor water, sanitation and hygiene facilities and services
Elderly people

If an epidemic occurs

Initiate community-based surveillance
Detect cases and refer them to health facilities
Provide oral rehydration (ORS)
Promote good food hygiene (thoroughly cooked food, covered food, clean utensils, etc.)
Encourage breastfeeding, including when the baby or child is sick
Promote safe, clean water (including a clean, covered water container in the household)
Promote use of appropriate sanitation facilities (sound, clean latrines)
Promote handwashing with soap (especially after using the toilet or cleaning a baby)
Increase social mobilization and behaviour change communication
Promote recommended health practices

Community-based assessment - questions

Make a map of the community and mark the information you gather on the map. Record other details.

When did people start to fall sick with diarrhoea?
How many people have fallen sick with bloody diarrhoea? Where?
How many people have died from bloody diarrhoea? Where? When?
How many people live in the affected community or area?
How many children under five years of age live in the affected area?
Who and where are the vulnerable people?
Are children in the affected community generally well nourished?
Do people always have enough food?
How common is breastfeeding?
Where do people obtain their drinking water? Is the source safe?
Do people know how to treat water? How do they do it?
What sanitation facilities (including communal latrines) are available? Do people use them?
What handwashing facilities are available? Do they have soap?
Where are the local health facilities and services? (Include traditional and community carers.)
What are the community’s habits, practices and beliefs about caring for and feeding sick people? When babies and infants are sick, do women continue to breastfeed them?
Is a social mobilization or health promotion programme in place?
What are the community’s habits, practices and beliefs about hygiene, sanitation and water?
Which sources or channels of information do people use most?
Are rumours or is misinformation about bloody diarrhoea spreading in the community?
Can people identify the signs and symptoms of dehydration?
Do people know how to make oral rehydration solution (ORS)? Do they have resources at hand to make it?

Volunteer actions

01. Community-based surveillance 02. Community mapping 03. Communicating with the community 04. Referral to health facilities 05. Volunteer protection and safety 07. Assessment of dehydration 09. Preparing oral rehydration solution (ORS) 10. Giving oral rehydration solution (ORS) 12. Managing fever 13. Breastfeeding 19. Psychosocial support 29. Hygiene promotion 30. Clean, safe household water 31. Good food hygiene 32. Sanitation 33. Building and maintaining latrines 34. Handwashing with soap 39. Preparing and using disinfectants 43. Social mobilization and behaviour change